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New Malingering Scales for the MMPI-2 (Better to look at external data)

I am often asked about faking on the MMPI-2. Let me start with Faking to Look Bad. Detecting Malingering is hard on any Self-Report. Adding more scales from more self report methodology is of little real help. (I mainly use the F scale, and then look outside of the test.) It is much better to do a good document check and get a detailed history. Here are some studies on some of the newer “malingering scales.”

F-r and FP-r on the MMPI–2-RF (Restructured Form) may show promise. Too soon to tell. But the MMPI-RF is not an MMPI. There is also not enough research behind it to take it to court at the present time. (By Sellbom, Martin; Toomey, Joseph A.; Wygant, Dustin B.; Kucharski, L. Thomas; Duncan, Scott Psychological Assessment, Vol 22(1), Mar 2010, 22-31.)

M-DFI not better than F The malingering discriminant function index (M-DFI), recently developed by Bacchiochi and Bagby tested with Logistic regression analysis (LRA) revealed that the MMPI-2 infrequency (F) scale had the best predictive utility of the traditional infrequency scales. Although the M-DFI did significantly differentiate the malingering from the not malingering groups, it did not add significantly to the predictive utility of the MMPI-2 F scale. (The utility of the MMPI-2 Malingering Discriminant Function Index in the detection of malingering: A study of criminal defendants. By Toomey, Joseph A.; Kucharski, L. Thomas; Duncan, Scott Assessment, Vol 16(1), Mar 2009, 115-121.)

The MMPI-2 Malingering Discriminant Function Index (M-DFI) was designed to detect malingerers educated about MMPI-2 validity indicators. Logistic regression analyses indicated that although the M-DFI performed better than several individual indicators, results were mixed for combinations of indicators, and the M-DFI did not outperform different sets of existing indicators. (Diagnostic accuracy of the MMPI-2 Malingering Discriminant Function Index in the detection of malingering among inmates. By Steffan, Jarrod S.; Morgan, Robert D. Journal of Personality Assessment, Vol 90(4), Jul-Aug 2008, 392-398.)

High F and extremely high clinical scores that are not clinically observable- The MMPI-2 validity scales differentiated malingerers from non malingerers with a high degree of accuracy. Hypochondriasis and Hysteria were also effective. For all variables except Scale L, more extreme scores were associated with higher specificity. (Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: A known-groups study. By Bianchini, Kevin J.; Etherton, Joseph L.; Greve, Kevin W.; Heinly, Matthew T.; Meyers, John E. Assessment, Vol 15(4), Dec 2008, 435-449.)

FBS has problems- FBS were able to distinguish only the noncoached participants instructed to fake from the PTSD claimants; in contrast, the F, FB, and Fp scales were able to distinguish both the noncoached and the validity-scale-coached participants from the PTSD claimants. (The utility and comparative incremental validity of the MMPI-2 and Trauma symptom Inventory validity scales in the detection of feigned PTSD. By Efendov, Adele A.; Sellbom, Martin; Bagby, R. Michael Psychological Assessment, Vol 20(4), Dec 2008, 317-326.)

The results indicate that the FBS is more likely to measure general maladjustment and somatic complaints rather than malingering. The rate of false positives produced by the scale is unacceptably high, especially in psychiatric settings. The scale is likely to classify an unacceptably large number of individuals who are experiencing genuine psychological distress as malingerers. (The construct validity of the Lees-Haley Fake Bad Scale: Does this scale measure somatic malingering and feigned emotional distress? By Butcher, James N.; Arbisi, Paul A.; Atlis, Mera M.; McNulty, John L. Archives of Clinical Neuropsychology, Vol 23(7-8), Nov-Dec 2008, 855-864.)

RBS scale may be helpful with exaggerated memory complaints- Exaggerated memory complaints are a common feature of cognitive response bias. Response Bias Scale (RBS) is sensitive to memory complaints and was tested against other MMPI-2 validity scales and indices. Regression analyses indicated that the RBS was a better predictor of the mean memory complaints score than the F, FB, and FP validity scales and the FBS. (Differential sensitivity of the Response Bias Scale (RBS) and MMPI-2 validity scales to memory complaints. By Gervais, Roger O.; Ben-Porath, Yossef S.; Wygant, Dustin B.; Green, Paul The Clinical Neuropsychologist, Vol 22(6), Dec 2008, 1061-1079.)

MMDS A new 15-item MMPI-2 subscale, the Malingered Mood Disorder Scale (MMDS), was empirically derived from the original 32-item Malingered Depression Scale (MDS) of Steffan, Clopton, and Morgan (2003). The MMDS was superior to the original MDS in identification of symptom exaggeration in personal injury litigants and disability claimants compared to non-litigating head-injured controls. (Empirical derivation of a new MMPI-2 scale for identifying probable malingering in personal injury litigants and disability claimants: The 15-item Malingered Mood Disorder Scale (MMDS) By Henry, George K.; Heilbronner, Robert L.; Mittenberg, Wiley; Enders, Craig; Roberts, Darci M. The Clinical Neuropsychologist, Vol 22(1), Jan 2008, 158-168.)

Underreporting, over-reporting neurotic level symptoms, insufficient cognitive effort, over-reporting psychotic level symptoms- The four factors were designated as follows: Factor I, with large loadings from L, K, and S–underreporting of psychological symptoms; Factor II, with large loadings from FBS, RBS, and Md–overreporting of neurotic symptoms; Factor III, with large loadings from VSVT, TOMM, and LMT–insufficient cognitive effort; and Factor IV, with the largest loadings from F, Fp, and Dsr2–overreporting of psychotic/rarely endorsed symptoms. Results reflect the heterogeneity of response validity in forensic samples referred for neuropsychological evaluation. (Response validity in forensic neuropsychology: Exploratory factor analytic evidence of distinct cognitive and psychological constructs. By Nelson, Nathaniel W.; Sweet, Jerry J.; Berry, David T. R.; Bryant, Fred B.; Granacher, Robert P.Journal of the International Neuropsychological Society, Vol 13(3), May 2007)

Fc scale in criminal settings- E. I. Megargee (2004) developed a Minnesota Multiphasic Personality Inventory (MMPI-2) Infrequency scale for use in criminal settings called the Criminal Offender Infrequency (Fc) scale. Results from this study suggest Fc may be a useful addition to the MMPI-2 for detecting malingering in criminal settings. (Accuracy of Megargee’s Criminal Offender Infrequency (FC) Scale in detecting malingering among forensic examinees. By Gassen, Michael D.; Pietz, Christina A.; Spray, Beverly J.; Denney, Robert L. Criminal Justice and Behavior, Vol 34(4), Apr 2007, 493-504)

Fp P. A. Arbisi and Y. S. Ben-Porath (1995) originally proposed that the Infrequency Psychopathology scale, F(p), be used as the final step in an algorithm to determine the validity of a Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocol. These results support Arbisi and Ben-Porath’s original proposal to use F(p) to identify a distinct subgroup of overreported MMPI-2 protocols within forensic psychiatric examinees with high elevations on F. (Evaluating the latent structure of the MMPI-2 F(p) scale in a forensic sample: A taxometric analysis. By Strong, David R.; Glassmire, David M.; Frederick, Richard I.; Greene, Roger L. Psychological Assessment, Vol 18(3), Sep 2006, 250-261.)

Fptsd scale The Infrequency-Posttraumatic Stress Disorder scale (Fptsd) was developed with combat-exposed PTSD patients. Based on the results, Fptsd may be more appropriate for combat trauma victims, and Fp may be more appropriate for civilian trauma victims. (Discriminating malingered from genuine civilian posttraumatic stress disorder: A validation of three MMPI-2 infrequency scales (F, Fp, and Fptsd). By Elhai, Jon D.; Naifeh, James A.; Zucker, Irene S.; Gold, Steven N.; Deitsch, Sarah E.; Frueh, B. Christopher Assessment, Vol 11(2), Jun 2004, 139-144.)

Finally, do not think in terms of a malingering-honest dichotomy-

These results were more consistent with dimensional latent structure than with taxonic latent structure. On the basis of these findings, it is concluded that feigned psychopathology forms a dimension (levels of fabrication or exaggeration) rather than a taxon (malingering-honest dichotomy) and that malingering is a quantitative distinction rather than a qualitative one. (Malingering as a categorical or dimensional construct: The latent structure of feigned psychopathology as measured by the SIRS and MMPI-2. (By Walters, Glenn D.; Rogers, Richard; Berry, David T. R.; Miller, Holly A.; Duncan, Scott A.; McCusker, Paul J.; Payne, Joshua W.; Granacher, Robert P., Jr. Psychological Assessment, Vol 20(3), Sep 2008, 238-247.)

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